Paul M Petelin Jr., MD – Ophthalmology Physician

Key facts

NPI: 1245328871
Entity type: Individual (NPI type 1)
Primary specialty: Ophthalmology Physician 207W00000X
License: 29999 (AZ)
Practice address: 14269 N 87TH St Ste 203
Scottsdale, AZ 85260-3695
Phone: (480) 483-8882
Fax: (480) 563-1413
NPI assigned: Oct 10, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Scottsdale Center for Sight, PLC Ophthalmology Physician · Scottsdale, AZ · NPI 1265591374

Medicare reassignment Care Compare group NPD AZ · OPHTHALMOLOGY
Scottsdale Eye Surgery Center, P.C Ambulatory Surgical Clinic/Center · Scottsdale, AZ · NPI 1295710002

NPD
Eye Physicians & Surgeons of Arizona, PC Ophthalmology Physician · Glendale, AZ · NPI 1124140504

NPD (past) OPHTHALMOLOGY
Priority Hearing and Balance LLC Audiologist · San Tan Valley, AZ · NPI 1962882746

NPD (past)
Tara Ransdell OD PLLC Optometrist · Peoria, AZ · NPI 1104914316

NPD (past)

Medicare Care Compare profile

Specialty: Ophthalmology
Education: University of Arizona College of Medicine, 1997
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Scottsdale Center for Sight, PLC (9 clinicians)

Practice addresses (Care Compare)

14269 N 87TH St
Suite 203
Scottsdale, AZ 85260-3695
Phone (480) 483-8882

Procedures performed for Medicare patients

Procedure	Number of procedures
Cataract surgery	1012

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AZ
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20141111002075	AZ	Practitioner - Ophthalmology	4789679614	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
5845	AZ	MD	Dental Hygienist
29999	AZ	MD	Ophthalmology Physician

Practice roles

Organization	Specialty	Status	New patients
Scottsdale Eye Surgery Center, P.C		Current	Accepting new patients
Scottsdale Center for Sight, PLC	Ophthalmology	Current since Mar 17, 2004	Accepting new patients
Tara Ransdell OD PLLC		Past since Sep 16, 2017	Accepting new patients
Eye Physicians & Surgeons of Arizona, PC	Ophthalmology	Past	Accepting new patients
Priority Hearing and Balance LLC		Past since Mar 1, 2021	Accepting new patients

Locations

36889 N Tom Darlington Dr
Ste A2
Carefree, AZ 85377
Phone (480) 483-8882

36889 N Tom Darlington Dr
Carefree, AZ 85377
Phone (480) 488-9220

36889 N Tom Darlington Dr
Ste 2
Carefree, AZ 85377
Phone (480) 488-8113

545 N Peart Rd
Casa Grande, AZ 85122
Phone (520) 316-5590

2490 W Ray Rd
Ste 4
Chandler, AZ 85224
Phone (480) 857-3333

41664 W Smith Enke Rd
Ste 110
Maricopa, AZ 85138
Phone (480) 331-6521

7727 W Deer Valley Rd
Ste E200
Peoria, AZ 85382
Phone (623) 376-9070

7727 W Deer Valley Rd
Ste 200
Peoria, AZ 85382
Phone (623) 376-9070

2222 E Camelback Rd
Ste 260
Phoenix, AZ 85016
Phone (602) 840-3501

33300 N 32nd Ave
Ste 205
Phoenix, AZ 85085
Phone (602) 962-0071

3330 N 2nd St
Ste 600
Phoenix, AZ 85012
Phone (602) 263-9345

8414 N 90th St
Scottsdale, AZ 85258
Phone (480) 949-1208

14275 N 87th St
Ste 112
Scottsdale, AZ 85260
Phone (480) 483-8882

10619 N Hayden Rd
Ste 101
Scottsdale, AZ 85260
Phone (480) 948-0733

14269 N 87th St
Ste 203
Scottsdale, AZ 85260
Phone (480) 483-8882

13613 W Camino del Sol
Ste 2
Sun City West, AZ 85375
Phone (480) 483-8882

10440 E Riggs Rd
Ste 160
Sun Lakes, AZ 85248
Phone (480) 505-2450

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/1615/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ophthalmology Physician	207W00000X	29999	AZ	Yes

Addresses

Primary practice location

14269 N 87TH St Ste 203
Scottsdale, AZ 85260-3695

Mailing address

14269 N 87TH St Ste 203
Scottsdale, AZ 85260-3695
Phone (480) 483-8882

Other practice location 1

545 N Peart Rd
Casa Grande, AZ 85122-5344
Phone (480) 895-9000

Other practice location 2

10440 E Riggs Rd Ste 160
Sun Lakes, AZ 85248-7757
Phone (480) 895-8900

Other practice location 3

10619 N Hayden Rd Ste 101
Scottsdale, AZ 85260-8510
Phone (480) 948-0733

Other practice location 4

13613 W Camino Del Sol Ste 2
Sun City West, AZ 85375-4480
Phone (623) 584-2100

Other practice location 5

36889 N Tom Darligton Dr
Suite 2
Carefree, AZ 85377
Phone (480) 488-8113

Other practice location 6

7727 W Deer Valley Rd Ste 200
Peoria, AZ 85382-2120
Phone (623) 376-9070

Other practice location 7

2490 W Ray Rd Ste 4
Chandler, AZ 85224-3559
Phone (480) 857-3333

Other providers in Scottsdale, AZ

All providers in Scottsdale, AZ · Ophthalmology Physician in Arizona

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.